Provider First Line Business Practice Location Address:
230 SAINT DAVID STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HALIFAX
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27839
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-532-0057
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/30/2006